Whoa, wait a minute

A 7 year-old, well appearing patient presented yesterday with fever and pain with urination. The medical student described the history and physical exam, and then launched into his diagnosis:

“The patient has malaria that caused him to be susceptible to an ear infection. The ear infection spread to his blood (sepsis) and then caused him to have an infection in the urine.”

I immediately stated that we should wait for his malaria test to return and that his ear was normal. We also established that he had no signs of sepsis.

The following day the medical student presented the patient to the large group of doctors. I was relieved when he gave the diagnosis simply as a urinary tract infection. If he had given his previous diagnosis, people would have wondered what the hell I was teaching in pediatrics.

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